Quick facts

  • Active ingredient: domperidone
  • Therapeutic area: gastrointestinal tract symptoms
  • Typical tablet strength where marketed: 10 mg
  • Common formulations globally: tablets, oral suspension

What Motilium is used for

Outside the USA, Motilium may be recommended by clinicians for several indications. Order of items is not a ranking of importance.

  • As an adjunct during radiologic evaluation of the upper gastrointestinal tract to help gastric emptying
  • As an antiemetic in patients receiving cytotoxic chemotherapy or radiation therapy
  • Control of nausea and vomiting of central or local origin
  • Symptoms linked to delayed gastric emptying of functional origin, such as reflux and dyspepsia

See how to take it in Dosage and directions, and review safety considerations in Safety warnings.

Dosage and directions

Always follow the instructions of your own clinician. Because domperidone is not FDA-approved in the USA, dosing below reflects practices from markets where it is authorized and is offered only as general reference.

Timing: take oral doses before meals. If you miss a dose, take it when remembered unless it is close to the next dose; skip the missed one and resume your normal schedule. Do not double up.

Lactose warning: Motilium tablets contain lactose and may not be appropriate for individuals with lactose intolerance, glucose-galactose malabsorption, or galactosemia.

Suggested regimens where approved

  • Acute symptoms such as nausea, vomiting, hiccup: - Adults: 20 mg (two 10 mg tablets) 3 to 4 times daily, 15 to 30 minutes before meals and, if needed, at bedtime.
  • Acute symptoms in children 5 to 12 years: 10 mg (one 10 mg tablet) 3 to 4 times daily on the same schedule.
  • Chronic dyspeptic symptoms: - Adults: 10 mg three times daily before meals; some patients may require up to double this dose if directed by a clinician.
  • Chronic symptoms in children 5 to 12 years: 5 mg (half a 10 mg tablet) 3 to 4 times daily.

Pediatric suitability: this tablet strength is not appropriate for children under 5 years; an oral suspension is used in that age group where approved. Tablets are not suitable for children weighing less than 35 kg.

Special populations

Renal impairment: in severe renal insufficiency (for example, serum creatinine greater than approximately 6 mg/100 mL or 0.6 mmol/L), the elimination half-life of domperidone can increase from about 7.4 to about 20.8 hours. Dosing frequency is commonly reduced to once or twice daily, and total daily dose may also need reduction. Monitor closely if therapy is prolonged.

Hepatic impairment: decreased liver function is a contraindication in many jurisdictions. See Safety warnings.

Storage and handling

Store between 68 and 77 degrees F (20 to 25 degrees C). Shield from heat, moisture, and light. Avoid bathroom storage. Keep out of reach of children and pets.

Safety warnings and precautions

Do not use if any of the following apply

  • Known hypersensitivity to domperidone or any tablet component
  • Current pregnancy, planned pregnancy, or breastfeeding unless your clinician judges benefit outweighs risk
  • Moderate to severe hepatic impairment
  • Confirmed or suspected prolactin-secreting pituitary tumor (prolactinoma)
  • Situations where increased GI motility is unsafe, such as GI bleeding, perforation, or obstruction

Cardiac risk note

Domperidone may prolong the QT interval and has been associated with ventricular arrhythmias and sudden cardiac death, particularly at higher doses, in older patients, or when combined with drugs that increase domperidone blood levels or themselves prolong the QT interval. Seek urgent care for palpitations, syncope, or new chest discomfort.

Pregnancy and lactation

Human data are limited. Use during pregnancy only if the expected benefit to the mother clearly outweighs potential fetal risk. Small amounts appear in breast milk; routine use while breastfeeding is generally not recommended unless specifically advised by a clinician monitoring for risks and benefits.

For questions about your specific situation, speak to your healthcare provider and review USA legal status if you are located in the United States.

Drug and substance interactions

Tell your doctor and pharmacist about all prescription, over-the-counter, and herbal products you use. Some agents can reduce effectiveness or increase risks:

  • Antimuscarinics that slow gut movement: antispasmodics such as atropine, hyoscine, propantheline; agents for urinary urgency like oxybutynin, tolterodine, propiverine, trospium; and antiparkinsonian anticholinergics such as procyclidine, trihexyphenidyl, orphenadrine
  • Strong opioid analgesics (for example, morphine, codeine) which may counteract GI prokinetic effects
  • CYP3A4 inhibitors that can raise domperidone exposure and cardiac risk: macrolide antibiotics (clarithromycin, erythromycin), azole antifungals (ketoconazole, itraconazole), certain HIV protease inhibitors, and grapefruit products
  • Other QT-prolonging drugs: some antiarrhythmics, certain antipsychotics, tricyclics, some fluoroquinolones, and others

This is not a complete list. Discuss any new or stopped medicines with your clinician before changing your regimen.

Possible side effects

Not everyone experiences adverse effects, but the following have been reported:

  • Rare: elevated prolactin (hyperprolactinemia) with effects such as galactorrhea, gynecomastia, or menstrual irregularities; reduced libido in men
  • Very rare: abdominal cramp, diarrhea, urticaria
  • Very rare but serious: extrapyramidal symptoms (tremor, stiffness, abnormal movements of the face, eyes, tongue, neck, or limbs) - seek medical attention promptly
  • Important: cardiac arrhythmias including QT prolongation, palpitations, syncope, or sudden cardiac events - get urgent care if these occur
  • Allergic reactions of varying severity

If you suspect a side effect, contact a healthcare professional immediately.

Alternatives and similar medications

Depending on your diagnosis, clinicians in the USA often consider FDA-approved options first. Examples include:

  • Metoclopramide (Reglan) - prokinetic and antiemetic. Effective for gastroparesis and nausea. Carries a boxed warning for tardive dyskinesia, especially with prolonged or high-dose use.
  • Ondansetron (Zofran) - serotonin 5-HT3 antagonist widely used for nausea and vomiting, including chemotherapy- or surgery-related.
  • Promethazine or prochlorperazine - dopamine antagonists with antihistamine or phenothiazine properties used for nausea; can cause sedation or extrapyramidal effects.
  • Erythromycin - motilin receptor agonist that can hasten gastric emptying; tachyphylaxis can occur and there are drug interaction concerns.
  • For reflux or dyspepsia symptoms: proton pump inhibitors (omeprazole, pantoprazole) or H2 blockers (famotidine) as symptom-directed therapy.
  • Motion sickness: meclizine or dimenhydrinate when appropriate.

If a domperidone-like prokinetic effect is desired, metoclopramide is typically the first-line FDA-approved agent in the USA. Discuss the risk-benefit profile of each alternative with your clinician.

Approximate price comparison in USD

Prices vary widely by pharmacy, location, insurance, and formulation. The figures below provide rough retail cash price ranges as of recent years:

  • Motilium/domperidone 10 mg tablets (outside the USA): approximately $0.10 to $0.50 per tablet for generics, and about $15 to $30 for a 30-tablet pack in some markets. Note: not legally marketed in the USA.
  • Metoclopramide 10 mg tablets (USA generic): about $4 to $15 for 30 tablets at discount pharmacies; higher at some outlets.
  • Ondansetron 4 mg tablets or ODT (USA generic): roughly $10 to $25 for 10 tablets; multi-dose packs can be more economical.
  • Erythromycin 250 mg tablets (USA generic): often $8 to $20 for common small quantities, but interaction profile must be considered.

Use discount programs or insurance formularies where available, and confirm current pricing with your pharmacy.

Additional notes

  • If you experience severe or worsening symptoms, seek medical attention promptly.
  • Regular re-evaluation is advised if therapy is continued for more than a few weeks, especially in older adults or those with cardiac risk factors.
  • Keep a complete list of all medicines and supplements you use and share it with every prescriber and pharmacist.